BMJ 1999;318:1505 ( 5 June )


Cycle helmets should not be compulsory

   Douglas Carnall
   , BMJ

   Cyclists are advised to wear helmets but legislation to make them
   compulsory is likely to reduce the number of people choosing to cycle
   and would not be in the interests of health, concludes the BMA's Board
   of Education and^ Science.

   International evidence shows that the compulsory use of helmets
   results in a fall in the number of cyclists. The Australian state of
   Victoria made the use of helmets compulsory in 1990, and in the
   following year deaths and head injuries among cyclists fell between
   37%and 51%However, 40%fewer adults and 60%fewer children continued to
   cycle after the introduction of the^ laws.

   About one in five cyclists in Britain currently wears a helmet. This
   proportion would have to be increased by promotional campaigns
   encouraging voluntary action before legislation could^ hope to be^

   Some cyclists are opposed to wearing helmets. Research by the European
   Cycling Federation found that non-cyclists tended to be most in favour
   of helmets. In fact, a much greater number of^ lives would be saved if
   pedestrians and car occupants were encouraged^ to wear helmets.

   The board's previous reports have concluded that the benefit to health
   of regular exercise from cycling outweighs the British cyclist's
   comparatively high risk of trauma. In countries such as the
   Netherlands and Denmark pedestrians and cyclists form a^ much smaller
   proportion of those injured or killed on the road, though helmets are
   little used. Instead, these countries have^ concentrated on safety
   programmes to reduce motor traffic speeds to 30 km/h in urban areas
   and separate cyclists from fast moving traffic.

   Properly fitted helmets manufactured to accepted standards can reduce
   the severity of head injury in a crash, though the tests on which
   these standards are based mimic a fall from a cycle rather than
   collision with a fast moving vehicle, which is most likely to harm an
   adult cyclist.

   Children are more likely to simply fall off their bicycles and may
   therefore derive more benefit from wearing a helmet. However, the cost
   --- between 12 and 90 --- and the necessity of replacing helmets
   every few years as the child grows may be^ prohibitive.

   The report recommends that the government should consider subsidising
   this cost, along with other measures to promote helmets manufactured
   to the highest standard (Snell B95). It also recommends that every
   child should be given the opportunity to learn cycling proficiency and
   that the driving test should be modified to test specifically for
   awareness of cyclists and other road users.

   Children may derive more benefit than adults from cycle helmets

   [20] BMJ 1999

Rapid responses:

   Read all [21]Rapid responses

   Falling Cyclists
          Phillip Brewer
, 4 Jun 1999 [22][Full text]

   Broken helmets
          Chris Gould
, 4 Jun 1999 [23][Full text]

   A poor argument to stop head injury
          Brian Boettcher
, 4 Jun 1999 [24][Full text]

   The New Jersey Experience
          Arthur L Yeager
, 4 Jun 1999 [25][Full text]

   Delighted to hear this
          Anthony Campbell
, 4 Jun 1999 [26][Full text]

   Misplaced fears about cycle helmets.
          Adrian Verrinder
, 4 Jun 1999 [27][Full text]

   Online Resource on Helmets
          Ernst Poulsen
, 5 Jun 1999 [28][Full text]

   Legislate or Encourage?
          Andy Reynolds
, 5 Jun 1999 [29][Full text]

   Wearing of helmets in sport may increase the chance of injury
          Duncan Sim
, 6 Jun 1999 [30][Full text]

          Giselle Noceti Ammon Xavier
, 6 Jun 1999 [31][Full text]

   The Inverse Safety Law
          David Carvel
, 8 Jun 1999 [32][Full text]

   Good but more science needed
          Avery Burdett
, 8 Jun 1999 [33][Full text]

   Why pick on cyclists?
          Anthony Cartmell
, 8 Jun 1999 [34][Full text]

   Saving even a few lives along the way must be worth making helmets
          Anna Linden
, 9 Jun 1999 [35][Full text]

   Re: Saving even a few lives along the way must be worth making helmets
          Andy Reynolds
, 9 Jun 1999 [36][Full text]

   speed kills
          John Rider
, 10 Jun 1999 [37][Full text]

   change in attitude, not helmets, reduce accidents involving cyclists
          Koen De Smet
, 11 Jun 1999 [38][Full text]

   Why I Don't Wear a Helmet
          Ken Kifer
, 14 Jun 1999 [39][Full text]

   Re: Donning of Lids - Good or Bad Idea?
          Dave Duffield
, 15 Jun 1999 [40][Full text]

   Compulsory wearing of cycle helmets
          K Lim
, 16 Jun 1999 [41][Full text]

   Cycling and helmets
          Kranti Kumar
, 16 Jun 1999 [42][Full text]

   Helmets and serious brain injury
          Bill Curnow
, 18 Jun 1999 [43][Full text]

   Mandatory helmet laws in Western Australia
          Chris Gillham
, 22 Jun 1999 [44][Full text]

   Compulsory wearing of cycle helmets is needed!
          A Fraser-Moodie
, 30 Jun 1999 [45][Full text]

   I fell, it hurt, it hurt my helmet more
          Tim Oates
, 30 Jun 1999 [46][Full text]

   Author's response
          Douglas Carnall
, 8 Jul 1999 [47][Full text]

   Re: Compulsory wearing of cycle helmets is needed!
          Chris Gillham
, 10 Jul 1999 [48][Full text]

   Policy on bicycle-helmet wearing
          Robert Ekman
, 13 Oct 1999 [49][Full text]

   Re: Policy on bicycle-helmet wearing
          Chris Gillham
, 15 Oct 1999 [50][Full text]

   Tricycles in Winter should be compulsory.
          Colin Guthrie
, 17 Oct 1999 [51][Full text]

   Re: Policy on bicycle-helmet wearing
          Brent Beach
, 19 Oct 1999 [52][Full text]

   Mandatory=No, By choice=Yes
          Bernard Labelle
, 29 Nov 1999 [53][Full text]

   Road Safety
          Malcolm Manby
, 22 Dec 1999 [54][Full text]

   Encouragement Might be Worse
          Ian Ker
, 14 Jan 2000 [55][Full text]

   Re: Encouragement Might be Worse
          Chris Gillham
, 8 Mar 2000 [56][Full text]

          Ward Parker
, 30 Jun 2000 [57][Full text]

   Re: unconstitutional
          Peter Morrell
, 2 Jul 2000 [58][Full text]

   Policy on bicycle-helmet wearing: reply from the Swedish Group
          Glenn Welander
, 5 Sep 2000 [59][Full text]

   No. Promote Cycling, not Helmets
          Malcolm Wardlaw
, 7 Sep 2000 [60][Full text]

   Reduction in Risk versus reduction in Freedom
          Kieran Brennan
, 4 Oct 2000 [61][Full text]